Hoarding

Compulsive hoarding is listed in the Diagnostic Statistical Manual-IV (DSM) as a symptom of obsessive compulsive disorder (OCD), which is characterised by the overriding compulsion to acquire new possessions and store them in excessive and often dangerous quantities.

According to Help for Hoarders, up to 3 million people are thought to suffer as hoarders in the UK.

Some compulsive hoarders collect anything and everything, some will collect only particular items, such as books (these people are known as bibliophiles) and some will even collect living creatures (known as animal hoarders). Any form of compulsive hoarding can seriously impair a person's physical and psychological health if left untreated. Support from a counsellor can help a hoarder to identify the underlying reasons for their hoarding and then learn how to control their compulsions.

Two of history's most cited and notorious compulsive hoarders are known as the Collyer brothers. They were found dead in 1947 after accumulating over 130 tonnes worth of possessions in their dilapidated New York mansion.

The brothers, named Homer and Langley Collyer, collected books, musical instruments, newspapers and other discarded objects in their large Harlem house, which they inherited when both of their parents died.

Both Homer and Langley were well educated and intelligent, having earned degrees in law and engineering, and embarked upon careers in law and music respectively.

Over the years, public interest in the eccentric brothers grew. Rumours began to circulate that they were sitting on a huge fortune with a house full of exceedingly valuable objects. These rumours encouraged numerous break-ins and prompted local teenagers to pelt rocks at the mansion windows.

As their anxieties and fears grew, the brothers became increasingly reclusive. They stopped leaving the house during the day and collected even more junk to form barricades and booby traps in order to deter the intruders. Eventually they stopped paying their bills and the authorities cut their water, gas and electric supplies, leaving the brothers to find food in rubbish bins and collect water from a pump in the nearby park.

Soon, Homer became handicapped with rheumatism and lost his eyesight after a haemorrhage. In response to a New York Herald journalist who enquired about the huge walls of stacked newspapers in the brothers' home, Langley declared: "I am saving newspapers for Homer, so that when he regains his sight he can catch up on the news."

Eventually, neighbours complained of a terrible stench emanating from the house. After the police managed to break in and tunnel through some of the junk, they found Homer no more than 10-hours dead on the floor.

Still unable to locate either the source of the smell or the other brother, police began to wonder whether he had in fact escaped the house. A few weeks later, however, workmen clearing the house found Langley's partially decomposed body crushed beneath a wall of newspapers, only a few feet away from where Homer's had been. Experts deduced that, upon trying to bring food to his paralysed brother through a tunnel of newspapers, Langley had been crushed by one of his own booby-traps. Homer, unable to move or fend for himself without his brother, had subsequently starved to death.

Workmen and police officers soon set to work clearing the house, removing a huge assortment of objects including guns, cameras, kerosene stoves, bowling balls, a child's chair, pickled human organs, 14 pianos and eight live cats. As well as finding stacks of (mostly worthless) junk, the workmen found the structure of the house itself decaying and falling apart, which is a common side-effect of hoarding.

Today, the site where the house once stood has been made into a public sitting area for adults known as 'Collyer's Park', which is still regularly visited by curious tourists.

Why do we hoard?

Where does the compulsion to hoard come from? Some experts believe hoarding is a survival instinct left over from when early man had to hunt and forage for himself. Observations show that many wild animals, including squirrels and birds, tend to hoard nuts, seeds and nest materials in time for the winter. Even domesticated animals like dogs and cats seem to hold onto this natural instinct despite having no need to hoard. For example, some dogs are known to build collections of balls or toys in their beds, or start burying objects in the garden. Similarly, cats have been known to build up rather macabre collections of dead animals that they bring into the house as 'presents' for their owners.

All humans hoard objects to a certain extent - in fact, our ability to hoard is thought to be the basis for our continued survival. The BBC documentary 'Walking with Cavemen' explains how homo sapiens managed to cross Asia and spread to other parts of the world simply because they were able to anticipate future situations, which gave them the foresight to store water in ostrich shells and therefore survive long periods of draught, something that co-existing hominids (such as homo erectus) failed to do.

Today, hoarding is still a fundamental part of our survival. Unlike wilder-beast, wolves, lions and other herd and pack animals, we do not migrate or roam across the land to chase our food - we build settlements and farm our resources. We plant crops, mine for fuel and breed livestock. Building up reserves, otherwise known as hoarding, is a fundamental part of staying put. But why does the hoarding instinct sometimes spiral out of control? What happens when we lose the ability to distinguish between vital reserves and unnecessary clutter?

Causes of compulsive hoarding

Many of us have wardrobes full of clothes we haven't worn for years, shelves stacked with books we rarely read and mantel pieces decorated with ornaments we hardly even notice anymore. When these hoards start to get out of control - for example, when we can no longer fit new clothes into our wardrobe, or when clutter starts to take over tables, most people will have a clean out. This might mean spending a day 'spring cleaning' by taking old clothes to charity shops, scrapping forgotten clutter, shredding old documents and so on. A compulsive hoarder, however, will never willingly throw anything away. He or she will simply acquire a new wardrobe or start stacking clothes on any available surface.

For a person who has never experienced or encountered any kind of obsessive compulsive disorder before, compulsive hoarding can be very difficult to understand. It may look like laziness, it may look like eccentricity, or it may look like plain greed. But more often than not, the problems run much deeper than that. So what really goes on in the mind of a compulsive hoarder?

Unique brain patterns

A study conducted in 2008 by the Department of Psychiatry at UC San Diego School of Medicine examined brain scans of compulsive hoarders and discovered abnormal activity in the part known as the 'bilateral anterior ventromedial prefrontal cortex' (BAVPC), or in layman's terms, a part at the back of the brain associated with decision making. This part is unique to mammals and is thought to be the most advanced part of the human brain. There have been several instances where brain damage (from strokes, infections, injuries etc.) has resulted in a patient developing compulsive hoarding habits. Interestingly, researchers found that these patients had impairments in the BAVPC, the same part of the brain thought to be responsible for compulsive hoarding in non-lesion patients, suggesting that this area plays a key role in compulsive hoarding.

Hereditary

Some experts believe that compulsive hoarding runs in the family. The 2008 study showed that up to 85% of compulsive hoarders could identify a relative who had the same problem.

Psycho-sexual development

Sigmund Freud (1856-1939), the father of psychoanalysis, believed that compulsive hoarding was linked with the 'anal' stage of child development. The 'anal' stage defines the period where very young children learn how to control their bowels and bladder through toilet training. He argued that positive and negative experiences during this stage would go on to determine an individual's future relationship with material objects. For instance:

Strict toilet training (such as being punished by parents for wetting the bed) tends to create an 'anal-retentive personality', where a person becomes obsessively tidy, organised and rigid throughout adult life.

Compulsive hoarding, along with other types of OCD, are thought to be symptoms of an anal-retentive personality. Hoarders are, by nature, very obsessive about the objects they collect and tend to become anxious and distressed at the mere thought of throwing them away. This desire to cling onto their possessions is, in Freudian terms, a by-product of their parents punishing them for a lack of bowel or bladder control during childhood. Therefore, the possessions they collect during adulthood are in fact subconscious representations of the 'possessions' they lost control of during childhood.

Today, Freud's theory is generally seen as out-dated and inaccurate but experts have yet to disprove it entirely.

Trauma

Some experts believe certain life experiences can be blamed for compulsive hoarding. For example, a person who experiences a tragic loss, such as the death of a close friend or family member, might start to place more importance on their material possessions because they are afraid of experiencing those feelings of loss again. Compulsive hoarders gain a sense of comfort from being surrounded by their possessions, which perhaps stems from the fear of being left with nothing at all.

Characteristics of a compulsive hoarder

A compulsive hoarder may...

buy lots of seemingly useless things

develop an emotional attachment to these items

find themselves unable to throw anything away

live limited lives due to junk taking over living spaces

put their health at risk due to unsanitary conditions

become increasingly isolated and unwilling to leave the house

deteriorate both physically and mentally

have other mental health problems such as depression and dementia

put neighbours, family and animals at risk of harm.

A hoarder's house

Compulsive hoarding often takes many years to become apparent. This is down to the obvious fact that it takes time to build up a large collection of items. What a hoarder's house looks like depends on how long their problem has gone unaddressed and who they live with. Sometimes a hoarder's tendencies will be curbed by spouses or children who help ensure clutter is cleared regularly. However, hoarders who live alone have no way to control their habit and this means things can get out of control very quickly.

Here is an example of an extreme compulsive hoarding case:

Imagine opening the front door of a house to find the hallway stacked floor-to-ceiling with papers, machines and other debris. There may be a pathway or tunnel cut through the junk to another room, such as the kitchen. Here you will find the surfaces stacked high with clothes, shoes and furniture interspersed with plates of rotting food. You try to enter the dining room but find the entrance completely blocked by stacks of chairs and books. The floor is littered with animal faeces and there is an overwhelming stench of ammonia. You find most of the rooms packed with junk and unsuitable for their original purposes. You also find damp, mould, mildew, rotting floorboards and disintegrating walls. The inhabitant of the house seems to have devised paths over the junk just to get from one side of a room to the other. These paths are known as 'goat trails' and are generally only visible to the hoarder him or herself.

Levels of damage

When clean-up companies are called in to clear out a hoarder's house, they will assess the severity according to a five-level scale. This is outlined in the table below:

Structure & zoning

Household functions

Pets and pests

Sanitation and cleanliness

Level 5

Structural damage/ no electrics or plumbing/

storing objects in appliances.

Bedroom and kitchen off-bounds due to clutter.

Rodent and insects infestations.

Evidence of human excrement/ rotting food/ lots of tinned produce.

Level 4

Structural damage to house/ evidence of mould and mildew.

Many rooms not used for original purpose.

More than four animals, evident animal waste, pet damage visible on furniture.

Rotting food/ evidence of lice /no clean dishes to eat from.

Level 3

Clutter visible from outside/ structural damage evident.

Small quantity of hazardous substance evidence.

Over three pets (excluding litters)/ visible animal faeces/ fleas

Obvious dirt, heavy smell and excessive dirty laundry.

Level 2

Exit blocked, ventilation/heating broken for minimum six months.

Unable to use two or more rooms due to clutter.

Pet odour/ evidence of accidents as well as pest infestation.

Rooms are grubby/dirty/dusty with potent smell and dirty laundry.

Level 1

All walkways,

exits, entrances and staircases accessible

Liveable conditions - clutter not excessive

Mild evidence of rodent/insect habitation.

No odours, generally hygienic.

A hoarder's personality

Although hoarding symptoms often become apparent around the age of 13 or 14 (where a teenager might place emotional significance upon seemingly useless debris, or attribute an identity to something like a teddy bear or a blanket), the symptoms usually only become very obvious and problematic during middle age (between 40 and 50 years old).

Hoarders are often very ashamed of their habit and will even avoid leaving the house so they won't have to face other people.

Risks of compulsive hoarding

Compulsive hoarding can have a detrimental effect on the physical and mental health of the hoarder, the hoarder's family and the hoarder's neighbours.

Hoarding can cause:

structural damage to a house and any connecting houses

eviction by landlords

infestations of rodents and insects

disease and infections which harbour in rotting foods

legal action by neighbours

fires

gas and water leaks because workmen are unable to access the wiring or plumbing

economic burden to society when the council spend money clearing the house only for a hoarder to fill up with junk again.

Compulsive hoarding and mental health

According to the DSM-IV, compulsive hoarding is a symptom of obsessive compulsive disorder.

25-40% of people with OCDs are thought to have symptoms of compulsive hoarding.

However, many experts believe it is a completely separate condition, with separate causes requiring separate treatment.

Compulsive hoarding is also closely related to a number of other mental health disorders, including depression, dementia and social anxiety.

Get help for compulsive hoarding

Compulsive hoarding is by nature a secretive habit. If you think your problem is getting out of hand, the first thing to do is throw away your pride and ask for help. Let family and friends know about it, or head to charity websites such as Help For Hoarders to share your experience and learn about others people's on the forum. With other people's support, you will find it easier to take the first step towards stopping hoarding.

Counselling for compulsive hoarding

Without guidance and support, you may find it difficult if not impossible to clear out your treasured possessions. Even hiring an external company to clean your house for you isn't going to solve the problems - within days you are likely to start building up a brand new collection of possessions.

Really, the problems come from inside you, not from inside your house.

Counselling can help you explore the problems that maybe you were not even aware of, change your patterns of thinking and help you learn how to make your own logical decisions.

Hoarding is often a symptom of hidden mental health problems, including depression, stress, anger or anxiety. In this case, counselling can encourage awareness and exploration in a safe and non-judgemental space with clear boundaries.

When faced with stressful events, some people choose to battle with a new problem of their own creating, like producing chaotic clutter as a way of avoiding their real problem. Skilled counselling can be useful in this circumstance.

If hoarding is beginning to get out of control then CBT might be helpful in managing the problem, and it can also help the sufferer develop decision-making skills. It is important for a hoarder to learn the difference between a necessary possession and a useless possession. Once they can adjust their patterns of thinking and stop associating the concept of 'possession' with control, or comfort, then they may finally be able to let go of their clutter.

For many people, hoarding symbolises a more unconscious or hidden problem which is being ‘acted out’. This might be connected to worthlessness or loss and this can be explored by psychodynamic or psychoanalytic counselling or psychotherapy which aim to make the unconscious more accessible and understood. At its most extreme, hoarding can be a defense against psychotic breakdown where the clutter comes to represent the mental state of chaos. The break-down of boundaries can be addressed in psychotherapy and the nature of filling space might be understood.

Sometimes hoarders attribute value to worthless articles which might reflect a person’s opinion of their own worth and value. If the hoarding does appears to be part of an obsessive compulsive disorder then specialist help should be sought.

What should I be looking for in a counsellor or psychotherapist?

Whilst there are no official rules and regulations in place that stipulate what level of training and experience a counsellor dealing with compulsive hoarding needs, we do recommend that you check your therapist is experienced in the area for which you are seeking help.

NHS Choices says the main treatment for hoarding is cognitive behavioural therapy (CBT) and that in some cases antidepressants can be helpful.

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